Putting People First: Personalisation Toolkit Planning for transformation framework: Stage summaries Gateway ref 9878 This document is part of the Personalisation Toolkoit, which can be seen in full at www.toolkit.personalisation.org.uk. Transition to transformation of adult social care

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Transition to transformation of adult social care

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Transition to transformation of adult social care When moving to transformation we have found that councils can: Clearly articulate the concepts and benefits of the transformation agenda Relatively easily put processes in place to manage trials However, we found that some councils: Struggle to communicate the scale of change required for total transformation to key stakeholders Find it difficult to plan activities required for total transformation Cannot always obtain a clear picture of the informal support that exists within the community Are not always clear on what decisions should be taken when, and by whom Don’t always have a clear picture of what the ‘future organisation’ looks like

Planning for transformation: introduction We have developed a Personalisation Toolkit that: Helps local councils understand what key decisions they need to take and in what order to move towards transformation Specifies the iterative transformation cycle and the products that are needed at each stage Suggests minimum and ideal levels of stakeholder buy-in and involvement in co-production at each stage Acknowledges that the planning for transformation framework itself is high-level and flexible

Planning for transformation: co-production Co-production is a key part of this agenda Real change can only happen by engaging users and carers throughout Personalisation means empowering people to develop solutions that work for them Putting People First… “seeks to be the first public service reform programme which is co-produced, co-developed, co-evaluated and recognises that real change will only be achieved through the participation of users and carers at every stage. It recognises that sustainable and meaningful change depends significantly on our capacity to empower people who use services and to win the hearts and minds of all stakeholders’, especially front line staff”

Trialling or piloting Trial phases happen separately from the strategic planning necessary for total transformation We recommend that councils undertake trial phases as soon as practical (in Investigation or Blueprint stage in “Phase One”) It is essential to understand that the processes and procedures put in place from the trial phases may differ significantly from those in the transformed service The practical lessons learned and parts of the process refined through trial phases are essential to being able to implement total transformation

Initiation The case for change is strong but resources still need to be committed to investigating transformation before further work can commence In this short stage, in order to progress to the next stage, the management team need to sign-off a resource plan outlining what will be required to properly investigate transformation and how these resources will be found Initiation

Investigation We recommend this stage start and end with a transformation strategy workshop with the management team The first workshop should be used to outline the principles, scope and success factors This should then give a sufficient basis to consult with key stakeholders, particularly people who use your services, and their families, members; relevant community support groups and senior staff in other council departments, to develop a vision, generate buy-in for self-directed support and the wider transformation agenda, and engage users in co-production The second strategy workshop with the management team should approve the developed vision, scope and success factors and allocate resources to developing a Blueprint A template slide pack for the initial workshop and report for the second is included as part of this toolkit toolkit.personalisation.org.uk Investigation

Investigation • Fit with existing initiatives • Many councils have plans, models or visions that reference self-directed support or personalisation. However, very few have a structure and change programme that is designed to deliver total transformation • Each council needs to take a strategic decision about how transformation will fit with existing initiatives • Many existing projects will be different but complementary to the introduction of transformation – such as those to introduce early intervention, enablement or crisis support services – work will need to be done through planning to establish the interface with the self-directed support system • This needs to take into account local circumstances including:• Capacity of the organisation to change• Existing service delivery arrangements (e.g. partnership delivery with PCT)• Level of commitment at senior level to transformation • We think councils have three basic options when aligning transformation with existing modernisation programmes

Investigation • Fit with existing initiatives • When assessing fit with existing initiatives it may be helpful to consider the following: • Do you have an existing change programme? • Do you have a well established programme and project management methodology? • Do you have project and programme resources? • Do you have a vision for change? • Is personalisation at the centre? • Does your programme meet the government’s requirements in ‘Transforming social care’:• Personalisation/self-directed support?• Common assessment of individual social care needs?• All individuals eligible for publicly-funded adult social care will have a personal budget?• Transparent allocation of resources?

Investigation • Fit with existing initiatives • When assessing fit with existing initiatives • it may be helpful to consider the following: • Many councils have plans, models or visions that reference self-directed support or personalisation. However very few have a structure and change programme that is designed to deliver total transformation. • Each council needs to take a strategic decision about how personalisation will fit with existing initiatives. • Many existing projects will be different but complementary to the introduction of transformation – such as those to introduce early intervention, enablement or crisis support services – work will need to be done through planning to establish the interface with the transformation system. • This needs to take into account local circumstances including:• Capacity of the organisation to change• Existing service delivery arrangements (e.g. partnership delivery with PCT)• Level of commitment at senior level to transformation. • We think councils have three basic options when aligning transformation with existing modernisation programmes.

Blueprint • Blueprint • The Blueprint stage is focused on determining the shape of the future organisation • We recommend that you start with how the organisation will look in the future, after the changes have been embedded • This is not about planning the detail of implementation or identifying all of the issues that will be faced in the first year • This stage will need to be repeated at the beginning of the “Switch On” and “Full Potential” phases to provide the opportunity to reshape the Blueprint based on evaluation feedback from the previous phase

Blueprint Blueprint There are two distinct phases to this stage: 1. Strategic decisionsConsidering the big questions about how the organisation will look.2. Operational designWorking out how these strategic decisions will look in practice. We recommend that this is initially at a fairly high level , and that it incorporate a degree of co-production.(i.e. not Business Process Re-engineering)

Blueprint • Target operating model • After developing a high level vision for transformation, local authorities need to develop a target operating model for their Blueprint in each phase • This is a detailed view of what the organisation will look like in the future • Very few councils have a target operation model that recognises the scale of change that total transformation entails • Most advanced councils have a vision underpinned by some financial data and a high level customer pathway with some aspects of the target operating model developed • It is assumed that, in line with Putting People First, this blueprint will be co-produced with people who use services and their families, including user-led organisations

Blueprint Suggested workstreams for developing the Blueprint Example: Specific organisation design work stream for entire customer journey Change Mngmt Org Design Finance ICT Process Example: Specific IT works team which also picks up process in some elements of the customer journey Governance Example: Work stream focused on particular element of customer journey

Implementation Planning • Implementation planning • Having established how your service will look in a few years time, this is now the stage to start planning how you will implement and produce a detailed plan for the first year • You will need to pay particular attention to:• Reengineering processes to fit the new ways of working• Training staff• Developing information systems• Working with current and potential suppliers in the voluntary and private sectors • Refining the resource allocation system

Implementation • Phasing implementation • Implementation will occur in each of the three phases of the iterative cycle. • There is no universally correct way to phase implementation • Potential criteria include:• Reengineering new clients/transitions/reviews• Locations• Client group • Type of current provision (services/cost)• Wide vs. deep (initial implementation with lots of people at a basic level or few people with higher quality) • You need to pick what is most appropriate for your locality

Implementation • Managing financial sustainability • When planning for implementation, it is important to devise a strategy that will be financially sustainable • Councils will need to consider where early savings will come from (to offset anticipated increase in demand):• High cost placements?• Process improvements to reduce inefficiency?• New users/transitions? • Transition arrangements may be needed for some individuals:• Person’s budget increases/stays same – none• Person’s budget decreases & in long-term residential care – transition arrangements may be needed • Person’s budget decreases but not in residential care – to be agreed on an individual basis

Monitor and Sustain • Monitor & sustain • The process and many of the tools you used will need to be continually improved • It is important to agree early on:• What to monitor• When to review• Who will take responsibility • This represents a major change – you shouldn’t expect to get everything right first time

Additional guides, examples and templates to support councils with their transformation programmes can be found at www.toolkit.personalisation.org.uk This framework and accompanying templates were developed by iMPOWER on behalf of the Department of Health. Thank you to the Individual Budget Pilot Sites, in particular to Lincolnshire, Barnsley, Oldham and other authorities, for support with the development and testing of this framework.